1. health and fitness

WHAT TO DO IN A
PSYCHIATRIC CRISIS
IN INDIANA
NAMI Indiana
P.O. Box 22697
Indianapolis, Indiana 46222
1-800-677-6442
www.namiindiana.org
PREFACE
TABLE of CONTENTS
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Planning Ahead. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 2
How Do I Prepare for a Mental Health Crisis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Who to Call in an Emergency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
How Do I Get Help Quickly?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Hospitals and Emergency Departments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Legal Basis for Detentions & Involuntary Commitment . . . . . . . . . . . . . . . . . . . . . 6
Detentions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Immediate Detention. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Emergency Detention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Physician/Judicial Hold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Commitments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Some Common Questions Concerning Commitment Proceedings . . . . . . . 10
Social Security: IMPORTANT! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Juveniles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
What You Can Do to Facilitate the Process . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Keeping a Mental Health History. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 13
Alternatives to Involuntary Commitment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Community Mental Health Centers in Indiana . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Resources & Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
When a person is in a psychiatric crisis, it is imperative to be able to get
him or her into treatment as quickly as possible. This can present a very significant challenge that we hope this booklet will help you meet successfully.
In the booklet itself, we will describe the general parameters of what to do
to get help in a psychiatric crisis. However, as you are probably aware, there are
29 Community Mental Health Centers (CMHCs) serving 92 counties in Indiana.
Each of these CMHCs has its unique set procedures, and we have found, when a
CMHC serves more than one county (and most of them do), there can be county-to-county variations in these procedures. We very much appreciate the
cooperation of our CMHCs in providing this information to us. It would be
hopeless to describe these variations in this booklet and keep it at a reasonable
size. Instead, the detailed information for each county will be listed on the
NAMI Indiana web site (www.namiindiana.org). In the event that you do not
have access to the Internet, this information can be obtained by calling the
NAMI Indiana Help Line (800-677-6442 or, in Indianapolis, 317-925-9399).
We sincerely hope that this booklet will help you in dealing effectively with
a psychiatric crisis. We realize, however, that it will have shortcomings, especially in this first edition. We heartily welcome any suggestions you have for its
improvement. Send your suggestion to NAMI Indiana, P.O. Box 22697,
Indianapolis, Indiana 46222, or by e-mail to Phyllis Patton ([email protected])
or Joe Vanable ([email protected]).
This booklet is the brainchild of Abby Flynn, who, up to the point of her
hospitalization for heart valve replacement surgery, chaired the committee that
produced it. Her drive, her focus, and her indomitable spirit provided the
wherewithal that made this booklet a reality. Sadly, Abby did not survive this
difficult surgery, and so she was deprived of the pleasure of seeing it actually
produced in final form. We dedicate this booklet to Abby’s memory; it is one
of many examples of the good things that have resulted from her very active
and fruitful life with NAMI Indiana.
If you read through this NAMI Indiana booklet and visit the accompanying
web site and you still do not find the answer to your question, you are not
alone. Of the 92 counties, few give identical services to people with mental illnesses. Feel free to contact the Community Mental Health Center(s) serving
your county for further clarification. Contact information will be found at each
of their web sites.
This is the very reason why NAMI Indiana Affiliates have been formed and
continue to be active in advocating for services. They persevere, they persevere,
they persevere; they never give up in working with the Community Mental
Health Centers to improve the services to our loved ones.
This is your opportunity to bring your question to light. Gather your NAMI
Indiana neighbors together and work with your Community Mental Health
Center for your loved one's services.
It works!
NAMI Indiana Crisis Booklet Committee
Indianapolis, October 2009
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ii
INTRODUCTION
Mental Illnesses are biological brain disorders that, untreated, can disrupt a
person's thinking, feelings, mood, or ability to relate to others in his or her daily
functioning. Most people with serious mental illnesses live successfully in their
communities as long as they have access to appropriate support and treatment.
Sometimes people stop taking their medications or their medications stop
working. In addition, some individuals with mental illness have anosognosia,
meaning that they are unaware of their mental illness, and so do not believe
they have a mental illness. They do not acknowledge their symptoms or have
insight into their illness and thus do not think they need treatment. All of
these things can result in people with mental illnesses not being able to care
for themselves or becoming a danger to themselves or to others.
In these situations, it may become necessary to have a court order to get
the person into treatment. The process of obtaining a court order is called the
Civil Commitment process. It has two main purposes:
• To treat persons with mental illnesses when they are unable or unwilling
to seek treatment voluntarily.
• To protect the person with mental illness and others from harm due to
the illness
The Civil Commitment process involves the legal system and can be confusing or intimidating for individuals with mental illness and their families. Civil
commitment can be a very emotionally difficult path to take and is viewed as a
last resort, when nothing else has worked.
Recent discoveries have shown that mental illness is very treatable with
medications and other therapies. At times, however, the medications may not
work well enough or people with mental illness may refuse to take their medications or see their doctor or therapist. When this happens, persons may
become isolated, and lose their job or even their housing. In some situations,
such persons may lead a life that involves homelessness, jail or prison.
Sometimes commitment is the only way to get a loved one back to functioning
better.
This booklet is designed to help individuals and families understand the
Civil Commitment process. First, this booklet provides suggestions for handling
mental health emergencies before the commitment process begins. Then, it
outlines the steps involved in the Civil Commitment process. Next, it explains
what happens if a person with mental illness is committed and discusses alternatives to involuntary commitment. Finally, contact information for Indiana’s
Community Mental Health Centers and additional resources are provided at the
end of this booklet. Throughout the booklet, people who have committed
loved ones provide advice and comments about the Civil Commitment process.
It is not an easy process; families need to understand the process and be strong
advocates for treatment, in order to gain access to it for their loved one.
“While initially my son was upset with the family over his commitment, in
the end he was thankful. He now lives in an apartment with community
supports and is working. Without the commitment I don't want to think
about where he would have ended up.” CL
“When deciding what is best for your loved one who has mental illness, the
reality is that you have only one choice. Hopes and dreams will have to
wait until – hopefully – a better day.” ET
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PLANNING AHEAD
Discuss with the person with mental illness the preparation of a Psychiatric
Advance Directive (PAD; discussed on p. 14) and the option of signing a Power
of Attorney and/or Appointment of a Health Care Representative.
Everyone should plan ahead by signing a Power of Attorney and appointing
a Health Care Representative. Anyone can suffer a medical crisis and be unable
temporarily to handle his or her own affairs.
Power of Attorney and Health Care Representatives can only be appointed
when a person is well enough to make his or her own decisions. A Power of
Attorney or Health Care Representative can only be used when a person is
unable due to illness or detention to make his or her own decisions.
This type of planning can help avoid court-ordered intervention or loss of
housing or property or benefits if the person becomes unable to act for himor herself.
These forms are simple to fill out and available on line, from your attorney,
or from many hospitals or organizations for the aged or disabled.
At the end of this booklet, you will find listed all of Indiana’s Community
Mental Health Centers, with addresses, phone numbers and web sites.
NAMI Indiana also provides county-specific information on “What to do in
a Psychiatric Crisis” on its web site, which may be found on the Internet at
www.namiindiana.org, or you can call 1-800-677-6422, and ask that a copy
of your county’s Mental Health Crisis Information to be mailed to you.
HOW DO I PREPARE FOR A MENTAL HEALTH CRISIS?
A mental health or behavioral emergency often triggers the concern of
family members or friends who may then consider Civil Commitment for the
person with mental illness. Knowing how to handle these emergencies requires
preparation. Having information about emergency rooms and the mental
health examiners who handle emergencies will better prepare you for helping a
person with mental illness in managing his mental health crisis.
To be well prepared for a crisis, collect and keep in an accessible place the
following:
1. The name, address, and phone number of the last known psychiatrist of
the person with mental illness. (Regardless of any release of information, this information is helpful for emergency responders.)
2. The name, address, and phone number of the last known therapist or
case manager of the person with mental illness.
3. A list of current medications or last known medications.
4. A list of any previous medications that resulted in serious side effects.
5. The diagnosis of the person with mental illness, if known.
6. Any medical diagnosis or condition such as diabetes, high blood pressure, seizure disorder or any other ongoing medical condition.
7. Information on the client’s use or abuse of alcohol, prescribed medications or illegal drugs. Be as realistic as possible as this information is
important in an emergency.
8. A list of the approximate dates and facility names of any previous hospitalizations.
9. Emergency numbers for the Community Mental Health Center or emergency-coordinating agency in the County in which your loved one resides.
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WHO TO CALL IN AN EMERGENCY
Assess the situation of the person with mental illness. If he or she is not in
immediate danger, call his or her psychiatrist, clinic nurse, therapist or case manager. If the hospital in your loved one’s area has a psychiatric service, many will
also have a crisis or assessment center. These centers also can provide assistance and advice. Or you may call your local Community Mental Health Center
or CMHC. Every CMHC has emergency services to advise, direct or assist in an
emergency, urgent situation or continuing decline of the person’s condition.
Remember: If your loved one does not live in your community, you
must be making all these inquiries and arrangements for facilities in the
county in which your loved one resides.
Some police departments will do what is generally known as a “well-being
check.” This may be appropriate if you have little information about the current
condition of the person with mental illness, but you have good reason to be
concerned. (For example, if you are used to seeing or talking with the person
frequently or at certain times and you cannot reach him or her, or if the person
has just called you and said something which causes you concern.) In such an
instance, you can call your local police department number to see if an officer
can check on the well being of a person with mental illness.
If you think the person with mental illness needs emergency medical or
psychiatric attention, drive him or her to the nearest emergency room if you
can do this safely.
If it is not safe to drive the person or s/he refuses, call 911 for an emergency response. If your community has a Police Department Crisis Intervention
Team (CIT), ask for a CIT officer. These officers have received advanced training
in responding to persons with mental illness who are in a crisis.
Keep the phone numbers for all of these resources where you can find
them in a hurry. Every community has a least two places to call: The
Community Mental Health Center, even if it is located in a different city, and
the local Police or Sheriff Department.
HOW DO I GET HELP QUICKLY?
If you are worried that the person with mental illness is in crisis or is nearing a crisis, there are ways that you can seek help. Before choosing which
option to pursue, assess the situation. Consider whether the person is in danger
of self-harm, or harming others or property, or if s/he is unable to manage daily
living. Consider whether you need emergency assistance, guidance or support.
"Need support? Call your local NAMI and arrange to visit them.
Membership is made up of families and friends of persons with serious
mental illness, as well as those who have mental illness, themselves. They
will become your best friends and be the best source of information to help
you and your mentally ill relative navigate the system of care and available
resources.” JN
Depending upon the situation, choose one of the following options:
1. If you do not believe the person is in immediate danger, call the person’s
psychiatrist, therapist, or case manager who is familiar with the person’s
history. This professional can help assess the situation and provide
advice for further action. The professional may be able to obtain an
appointment or may be able to admit the person to the hospital. If you
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cannot reach someone and the situation is worsening, do not continue
to wait for a return call. Take another action, such as:
2. Call the Emergency Services Department of the Community Mental
Health Center that serves the county where the patient lives.
3. If you think the person with mental illness needs emergency medical or
psychiatric attention, drive him or her to the nearest emergency room,
but only if you can do so safely.
4. If you do not think that you can do this safely, call 911 Emergency
Services. Ask for the Crisis Intervention Team or CIT member if your
community has this service, or your local hospital emergency services.
5. If you want advice, support and to have someone assess the situation,
contact the Emergency Services Department of your local Community
Mental Health Center. Information on how to contact Community
Mental Health Centers is listed in the back of this booklet.
If the situation is life threatening or if serious property damage is taking
place, call the police for assistance. When you call the police, tell them your
loved one is experiencing a mental health crisis, and explain the nature of the
emergency. If you have a Crisis Intervention Team in your area, ask for a CIT
officer. Telling the police that it is a crisis involving a person with mental illness increases the chance that an officer trained in working with persons with
mental illnesses will be dispatched. You can also call the police if you need
help transporting the person to the hospital during a crisis.
It is important to note that depending upon the police officer involved
and other contingencies, s/he may take your loved one to jail instead of to the
emergency room. Be clear about what you want to have happen.
When giving out information about a person in a mental health crisis,
always be very specific about the behaviors you are observing. Instead of saying, “my son is behaving strangely” you might say, “my son hasn’t slept in three
days, he hasn’t eaten anything substantive in over 5 days, and he believes that
the FBI is transmitting messages through his fillings.” Report any active psychotic behavior, and/or changes in behaviors (such as not leaving the house,
not taking showers), threats to other people, increase in manic behaviors, or
increase in agitation (pacing, irritability). You need to describe what is going on
right now, not what happened a year ago. Finally, in a crisis situation, when in
doubt, go out. Do not put yourself in harm’s way.
HOSPITALS and EMERGENCY DEPARTMENTS
Every hospital and emergency department has its own set of guidelines for
responding to a mental health crisis. Some hospitals have markedly improved
their preparedness and ability to handle mental health or behavioral crises.
While one may not be located near you, knowing what the best hospitals do in
these situations will help you know what to ask for. You may want to talk
ahead of time to the psychiatrist, other mental health professionals or other
families about which hospitals in your area have the best reputation for dealing
effectively with a mental health crisis.
At the emergency room, immediately inform the hospital staff that your
loved one is in a mental health crisis. Alerting the hospital staff to the nature
of the crisis can speed up the response of trained mental health professionals.
The staff will then know to use mental health evaluation forms and to follow
the correct assessment and admission protocols. Clearly state how the person
is in danger and describe the behaviors.
Find out if a separate emergency room is available for individuals experiencing a mental health crisis. A room separate from the standard, often chaotic,
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emergency room provides a less stressful setting where the person in crisis can
wait. Some hospitals have these and people report that it makes a difference.
Doctors and other examiners at the hospital should make an honest effort
to obtain information from the person who brings a potential patient to any
treatment facility. Be prepared to provide the following information about the
person in crisis to the medical examiner:
• Psychiatric history – Prepare an abbreviated history NOW and have it available for crisis situations when they occur. If you are just beginning this
process, keep a continuing diary of the person’s psychiatric history. You
can find a downloadable form on the NAMI Indiana web site that can help
you do this.
• Past behaviors and treatment including a current list of medications and
dosages.
• List your knowledge and direct observations of the recent behavior that
caused concern. It can be helpful to write down your observations leading
up to and during the crisis – be brief and concrete. You must provide
detailed information on how s/he is incapable of self-care, any suicide
threats, threats to property or others, new behaviors, etc.
• List current mental health providers and insurance information about the
person.
• If you wish to give information about your loved one, contact the
Emergency Room. Do not wait for them to call you.
It is a good idea to compile this information before an emergency occurs.
(And make extra copies; you’ll probably need several.) Write it down and keep
it easily accessible so that you are not pressed to remember the information
during a crisis.
“Departing the hospital after visiting our son, a gentleman I shared the elevator with stated in despair, ‘I cannot believe that my wife is in a locked
down ward.’ Many of us have also experienced this despair, but what we
must remember is that in this period of despair, this hospital is a place of
hope that being there can lead to the appropriate treatment and recovery.”
MK
Be prepared for a long wait in the emergency room. NAMI has heard that
individuals with mental illness and their families have waited eight or more hours
before being helped. It is important to note that bringing someone to an emergency room does not necessarily lead to an admission into the psychiatric unit.
Don’t be surprised if the emergency room physician asks you to assess how
dangerous the individual is to him or herself or others and asks if you would be
able to take the person home. Be prepared to hold your ground if you really
believe the individual needs to be hospitalized. Don’t take someone home if
you believe you cannot reasonably keep him or her – or others – safe.
Because of HIPAA restrictions, as a rule, doctors and other hospital personnel do not share information about an adult patient with the family, unless
s/he gives permission to do so. However, you can still provide information to
them that may help them assess the situation and provide better treatment.
You might also try asking broad questions such as “If I had a relative with schizophrenia, what medications would be recommended if X medication wasn’t
working?” If you have Power of Attorney, however, HIPAA restrictions do not
apply.
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LEGAL BASIS FOR DETENTIONS and INVOLUNTARY COMMITMENTS
A person cannot be detained or committed for treatment against his or her
will unless the individual meets certain legal standards. A detention or involuntary commitment is only authorized if:
• The person (1) suffers from a mental illness; and, (2) due to the mental illness is dangerous and/or gravely disabled.
• Mental illness is defined by statute as a psychiatric disorder that:
1. substantially disturbs an individual’s thinking, feeling, or behavior; and,
2. impairs the individual’s ability to function.
The term includes mental retardation, alcoholism and addiction to
narcotics or other dangerous drugs.
• Dangerous is defined as a condition in which an individual, as a result of
mental illness, presents a substantial risk that the individual will harm
him- or herself or others.
• Gravely disabled is defined to mean a condition in which an individual, as a
result of mental illness is in danger of coming to harm because the individual:
1. is unable to provide for his/her food, clothing, shelter or other essential human needs; or,
2. has a substantial impairment or obvious deterioration of his or her
judgment, reasoning or behavior that results in the individual’s inability
to function independently.
“Dealing with a psychiatric crisis is a daunting task that can be very, very
discouraging. In dealing with the challenges of such a crisis, it is important
to remember this: severe mental illness is treatable, more treatable than
cardiovascular disease. The key here is to have access to treatment. Your
effort in achieving this access for your loved one has the potential of providing rich dividends!” JV
Detentions
Indiana statute provides for three types of detentions. One type of detention is the immediate detention (commonly referred to as the 24-hour detention). The other type of detention is an emergency detention (commonly
referred to as the 72-hour detention). The primary purpose of the these two
types of detentions is to permit law enforcement officials or emergency medical
personnel to take an individual who is experiencing a mental health crisis into
custody for transportation to a local health care or psychiatric facility for assessment and emergency treatment. The third type of detention is a physician/judicial hold.
“If your son or daughter is in trouble with the law, and you feel the court
should know about his/her mental illness as it pertains to the case, it is
appropriate and beneficial to write a letter about his/her mental illness
and how it affected his/her judgment in the case before the court.
However, you must send three copies. One to the Judge, and Cc: copies to
the Public Defender and the Prosecuting Attorney. With the information
you have provided, they all three know the facts, and they can feel free to
discuss them with one another to arrive at a consensus about how to prosecute the case. I was advised to do this by our CMHC’s counselor, and it
worked! My son's misdemeanor was dropped and not prosecuted.” PP
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The statute grants immunity from liability for individuals who participate in
obtaining detention or commitment of a mentally ill person, so long as the
individual does not act with malice, bad faith or negligence.
Immediate Detention (24 hour detention)
The immediate detention (24 hour detention) can be utilized by a law
enforcement officer who has reasonable grounds to believe that the person in
crisis is mentally ill, dangerous and in immediate need of hospitalization and
treatment. The officer is authorized to take the person into custody for the
purpose of transporting the person to a local health care or psychiatric facility
In those cities or counties that have a CIT Program, the CIT officers use the
24 hour detention. The CIT officers are trained to conduct a field assessment to
determine if an immediate detention is necessary. Typically, the CIT officer will
assess whether the situation can be handled without a detention. However, if
the decision is made to exercise an immediate detention, the person is transported to an appropriate medical or psychiatric facility for the purpose of a
psychiatric assessment.
The psychiatric assessment must take place within 24 hours from the time
the individual is admitted into the facility. Depending on the assessment, the
assessor may release the person or decide to seek an emergency detention (72
hour) or a commitment.
Emergency Detention (72 hour detention)
An emergency detention can be initiated by a law enforcement officer,
emergency medical personnel, family, friends or anybody who believes that the
individual is (1) mentally ill and (2) either dangerous or gravely disabled and (3)
in need of immediate restraint. In order to obtain an emergency detention, a
petition must be signed by the party seeking the emergency detention. The
petition must include a medical statement from a physician that is based on
either a personal examination of the individual or on information provided to
the physician by a third party that indicates that the individual may be mentally
ill and is dangerous and/or gravely disabled.
If you are in a situation where you believe something dangerous is about
to happen to you, to others or to the person with mental illness, call the
police department or the local crisis intervention unit immediately. For
your sake, and for the sake of your loved one as well, it is imperative that
you not put yourself in harm’s way.
Sometimes a person with mental illness creates such a risk of injury that
s/he must be held in custody before a petition for commitment can be
filed. In these cases, an “emergency hold” can be placed to temporarily
confine the person in a secure facility. Emergency holds last for 24 hours
(not including weekends and holidays). An emergency hold does not necessarily result in starting the commitment process. It only serves as a way to
assess the individual to determine if commitment is necessary.
Once the petition has been prepared, the petition is submitted to a court.
This may be done in writing or orally. The court must approve the petition and
the approval may be in writing or orally. Once the court approves the petition,
a law enforcement officer is authorized to take the individual into custody and
to transport the individual to a health care or psychiatric facility. The length of
the detention is not to exceed 72 hours, commencing from the time the court
issues the order approving the detention; however, by statute, the 72 hours
excludes Saturdays, Sundays and legal holidays.
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During the detention, the individual is examined and assessed. If the physician determines that there is no probable cause to believe that the individual is
mentally ill and either dangerous or gravely disabled and in need of continuing
care and treatment, the individual is discharged from the facility. If the examining physician believes that probable cause does exist for continuing involuntary
detention, a report is filed with the court requesting an involuntary commitment
prior to the expiration of the 72-hour period. Within 24 hours of receiving the
report, a hearing on the petition for involuntary commitment must be scheduled
to take place no later than 2 days from the date of the receipt of the report.
The statute provides for the hearing to take place in two stages if the court
chooses to conduct the hearings in such a manner. If conducted in two stages,
the first stage is the scheduling of a preliminary hearing to determine if there is
probable cause to proceed with the involuntary commitment. If the court conducts a preliminary hearing and determines that there is probable cause to proceed with a hearing on the Petition for Involuntary Commitment, a final hearing
must be scheduled within 10 days of the date of the preliminary hearing.
Some courts conduct just one hearing and eliminate the need for both a
preliminary and final hearing.
Physician/Judicial Hold
A physician/judicial hold occurs when a person, having voluntarily agreed
to receive treatment in an in-patient setting, now desires to terminate the
treatment and leave the facility. The person must give written notice of his or
her desire to be released. The physician has 24 hours to make a decision as to
whether to release the patient. If the physician has reason to believe that the
patient is mentally ill and is dangerous and/or gravely disabled and in need of
continuing care and treatment, the physician has 5 days to file a written report
to the court in the county in which the patient is hospitalized, or is a resident,
and request a commitment hearing. The court will issue an order of judicial
hold. The judicial hold requires that the patient remain in the facility until the
hearing, which must occur within 2 days of the court receiving the physician’s
report. The hearing may be either a preliminary hearing or a final hearing. If a
preliminary hearing is conducted, the final hearing must occur within 10 days of
the preliminary hearing.
Commitments
There are two types of involuntary civil commitments. A temporary commitment is a commitment that is a period of time not to exceed 90 days. A regular commitment is a commitment for an indefinite period of time, subject to
mandatory annual review. An involuntary commitment authorizes the care
provider to provide treatment in a setting that the caretaker determines to be
the least restrictive given the existing psychiatric condition of the mentally ill
person. The care may be in-patient care in a local facility or at one of the state
operated mental health facilities. The care may consist of out-patient treatment with the person living in a sub-acute facility, a group home, or the person’s private residence.
For a temporary commitment, a petition is filed with a court in the county
in which the patient resides or where the patient is located.
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An involuntary civil commitment proceeding is typically initiated by the filing of a petition. The petitioner is the person seeking the commitment and the
respondent is the person that the petitioner is seeking to have committed. The
petitioner must be at least 18 years of age. The petitioner is often a member of
the staff of a treatment facility where the respondent is being treated, but the
petitioner can also be a family member, friend or someone in the community.
However, we recommend that whenever possible, family members NOT be petitioners. The petitioner does not always have to complete and file the petition
on his own. The person who prepares the actual petition may vary from county
to county. Treatment facilities may prepare their own petitions. In hospitals, a
social worker usually represents the hospital at the commitment hearing.
The petition must include a physician’s written statement whereby the
physician states that the physician has examined the respondent within the
past 30 days and that the physician believes that the respondent is mentally ill
and either dangerous or gravely disabled and in need of custody care or treatment in an appropriate facility.
The most important thing a family member can do to help with this is to
provide a documented mental health history of the person in crisis. This,
plus an understanding of Indiana law, will be the keys for you to find and
receive the services needed for your loved one. A form to help you do this
can be downloaded from the NAMI Indiana web site (www.namiindiana.org)
(This web site also contains specific information about managing a psychiatric crisis in the county in which it is occurring.)
Having this information written down will make it easier for you to remember events later on, especially if you testify in court during commitment
proceedings. Without notes, it might be hard for you to remember details
about who was there, what everyone said and what happened. You need
to be able to state why a commitment is necessary. Tell the team about
alternatives that have been tried and why the person needs treatment.
Upon receipt of the petition, the Court has 3 days to enter an order setting
a hearing date on the petition. The hearing must occur within 14 days from the
date of the order setting a hearing date, unless the petition is being filed at the
conclusion of an emergency detention, in which case the hearing must occur
within 2 days after receiving the report from the physician. (See the section on
emergency detentions on page 7.) Notice of the hearing must be given to the
petitioner and the respondent. If the respondent is being treated in a facility,
notice must be given to the facility.
At the hearing, testimony is offered by the petitioner and by a physician.
Perhaps other witnesses may have to be called to provide the evidence necessary for the court to determine whether the respondent meets the statutory
criteria of suffering from a mental illness and being dangerous and/or gravely
disabled. Generally, you can only testify about things that you have seen or
heard directly, not what you learned through talking to other people. Be sure
to dress appropriately for court, respond directly to the questions asked and
follow the directions of the judge.
There must be clear and convincing evidence that the respondent meets
the statutory criteria. If the court determines that there is clear and convincing
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evidence that the respondent meets the statutory criteria, the court enters an
order of involuntary commitment. The court will commit the respondent to
the care of an appropriate treatment facility. If the court determines that there
is no clear and convincing evidence that the respondent meets the statutory
criteria, the person is ordered released from any facility in which the individual
may be a patient and the petition is dismissed.
Sometimes it is difficult for family members of the mentally ill individual
to accept a court’s decision that the evidence offered does not clearly convince the court that the individual is mentally ill and dangerous and/or gravely
disabled. Oftentimes it is not difficult to prove that the individual suffers from
a mental illness; however, it is more difficult to prove that the mentally ill
respondent is dangerous and/or gravely disabled. In the event that the court
determines that the statutory criteria were not met, family members should
not be discouraged from pursuing petitions for commitment in the future if
there is a change in the factual circumstances of the mentally ill individual.
A temporary commitment may be extended for one additional period not
to exceed an additional 90 days. A petition for extension of a temporary commitment must be filed and the hearing conducted prior to the expiration of the
original temporary commitment. If any additional petition is filed after two temporary commitments, the additional petition must be for a regular commitment.
If a court orders a regular commitment, the court must schedule a date for
the filing of a report to court (known as a periodic report) which has to be at
least annually, since such a commitment is indefinite in length. The care
provider must file the periodic report if it believes that the statutory criteria
still exist for the commitment. If the court issues an order continuing the commitment, the respondent has the right to request a review hearing at which the
care provider must present evidence that the statutory criteria still exist for the
commitment.
An involuntary commitment may be terminated at any time by the care
provider if the care provider believes that the statutory criteria needed for the
commitment no longer exist.
Some Common Questions Concerning Commitment Proceedings
• Who can attend court proceedings?
In Indiana, hearings on involuntary civil commitments are confidential
and not open to the public. Typically the individuals who would be able
to attend the hearing are the petitioner, any witnesses necessary to prove
the petition, the physician, and court personnel. Members of the family
who are not the petitioner or appearing as witnesses may attend only if
the respondent consents to the presence of the family members in the
courtroom.
You can contact the clerk of the court to determine when and where
the hearing will be conducted.
• Can you communicate with the respondent prior to or after the hearing?
If the hearing occurs in the court and the respondent is an in-patient,
the respondent will typically be brought to the courtroom by law
enforcement officers, usually sheriff’s deputies. The law enforcement
officer is in charge of supervising and monitoring the patient. It is up to
the officer in charge and the court as to whether they will permit family
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members to sit with and/or communicate with the respondent before
or after the hearing. It is important for family members to be supportive
of the respondent through this process and while attending hearings. In
most instances, communicating with the individual is a gesture that most
respondents probably appreciate. It is valuable for preserving the relationship. If the person with the mental illness is being held in a facility
during the commitment process, family members may contact the treatment facility to arrange a visit.
“Be slow and methodical in what you say. Be accurate and honest. It helps
to bring in what you want to say in writing.” MG
“The system seems designed to not work very well. Don’t let frustration
stop you. Be persistent. Be assertive and even aggressive if necessary.
Always be respectful and speak with authority. Don’t assume anything and
always get everything in writing.” EE
"When I was newly into caring for my mentally ill son, I was not prepared
for the court hearing. I did not present my concerns forcefully enough about him not eating and no food in his house. When it was the psychiatrist's turn to speak, he said, ‘No comment"’ so the judge had to let my son
go. Be prepared when you go to court. Write down everything that causes
you concern, and fight for the mental health treatment that will help your
loved one, even if it involves commitment. My son was so sick that he
admitted himself to the same facility three days later.” PP
• What are the rights of the respondent?
A respondent must be given advance notice of a commitment hearing
and be present at the hearing and testify unless the respondent is disruptive or it is determined that it would be injurious to the respondent’s
mental health to participate in the hearing. The respondent is entitled to
receive a copy of the petition. A respondent is entitled to representation by an attorney. The attorney may be a private attorney; however,
most courts provide or appoint a public defender to represent a respondent in commitment proceedings.
• Who pays for commitment?
Just because you act as the petitioner does not mean you have to pay
for the person’s treatment. Treatment costs may be paid by: private
insurance, government programs, the individual with mental illness, or, in
rare instances, the county.
Although you should talk to the hospital staff or the county case manager about your specific situation to determine the cost and payment of
care, here are a few general guidelines to keep in mind:
Generally, who pays depends on where the care is given and what programs people are eligible for. If the patient is covered by a private
insurer, the insurer is billed. If the person is between the ages of 18 and
65 and has no insurance, the person is ultimately responsible for the
cost of treatment. In these cases, the person is usually committed to a
state facility and the facility will bill the person and his or her spouse
or guardian on the basis of his or her ability to pay. If the person is
unable or unwilling to pay for the treatment, the state can apply to be
payee of the person’s Social Security or VA benefits, file liens against
real estate owned by the patient or his or her spouse, file claims in his
or her guardianship, or file claims on his or her estate after death.
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“The public defender must represent the wishes of the person who is being
committed. This may seem very frustrating since your loved one’s wishes
may not coincide with his or her best interests.” DH
Social Security: IMPORTANT!
Very often, a person with severe and persistent mental illness is unable to
work and must depend on financial assistance from Social Security. Gaining
access to this support can take time, and so it is crucial that you contact Social
Security immediately after you get a diagnosis for your loved one. Call 1-800772-1213 (or use the web site www.socialsecurity.gov). Do this to establish your
intent to file an application, even if you don’t actually file an application during
this call. This will establish your protective filing date.
Social Security pays disability benefits through two programs – the Social
Security Disability program (SSD) and the Supplemental Security Income program (SSI).
After it has been determined that your loved one who has a mental illness
can no longer work, you can call Social Security to schedule an appointment to
file the actual application or go online and file the claim.
Juveniles
Indiana provides that a juvenile court may commit a child to a child-care
institution. A child care institution is defined as an institution operating under
a license issued by the state of Indiana that provides for the delivery of mental
services appropriate to a juvenile and complies with various rules adopted by
the Division of Family and Children Services. If the commitment or placement
of the child to a facility other than a child-care institution is necessary, commitment proceedings may still take place but would by done by the court that
would normally have jurisdiction of civil commitments. Oftentimes a commitment is not necessary because the parent or guardian is in the position to give
consent for the placement of the child into a hospital or mental health treatment center.
What You Can Do to Facilitate This Process
Contact NAMI Indiana, your local Community Mental Health Center, or
Mental Health America (formerly known as the Mental Health Association) to
assist family members or friends in the process.
The petition for commitment needs to be supported by the report of a
licensed physician or psychiatrist who has examined the person with mental illness within 30 days of the filing of the petition. The examiner must provide a
written statement describing the person’s diagnosis and behavior and stating
that the person needs to be committed. This is called the “support statement”
and becomes part of the petition.
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Keeping a Mental Health History
Here are some examples of questions you should be able to answer about
the person with mental illness; constructing a Mental Health History will make
it possible for you to do this. Refer to the NAMI Indiana web site (www.namiindiana.org) for a downloadable form that can help with this. It is worth
pointing out that being prepared with this information can also be invaluable in
applying for Social Security Disability benefits.
• Background information:
Name, age, current location/address, social security number, and names of
family members.
• Behavior:
Has s/he made verbal or physical threats? Is s/he verbally or physically abusive?
Has s/he mentioned suicidal thoughts or plans? Has s/he attempted suicide?
Has s/he he acted irrationally?
• Diagnosis/Symptoms:
What is his or her diagnosis? Why do you believe s/he has a mental illness?
What signs and symptoms do you see?
• Medical care providers:
Does s/he have a therapist, psychiatrist or other doctors? Who are they
and how can they be reached?
• Mental health treatment history:
Has s/he been hospitalized or received outpatient care? If so, when (year
and month) and where?
• Medications:
What medications have been prescribed? Does s/he take the medication
as prescribed? Did they help? Did they have severe side effects? What
medications was s/he on in the past?
“Never give up hope. Know your rights. Keep records of your loved one’s
behavior. Work with the system and make the system work for you”. EE
“We need to advocate and support pharmaceutical companies that risk a
lot to seek new and more effective medications to help our loved-ones
have a better chance at effective recovery from these biological brainbased disorders that we call mental illnesses”. JL
• Overall health:
Does s/he have health problems in addition to his or her mental illness?
What are they?
• Alcohol and other drug use:
Does s/he use alcohol or other drugs? Has s/he admitted to alcohol or
other drug use? Which drugs does s/he use? How much and where does
s/he get them? How does s/he pay for them? Have you seen the person
high or intoxicated?
• Weapons:
Does s/he have access to a gun or other weapon?
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• Police record, court involvement, accidents:
Has s/he ever been arrested, spent time in jail or prison? List dates and
charges.
• Self-care:
Does s/he shower, change clothes, and wash clothes? Does s/he do dishes
and keep the house/apartment clean?
• Diet:
Is the person eating? Has s/he lost or gained weight? If so, how much and
over how much time?
• Sleep:
Is the person able to sleep? If not, how many days have there been with
out sleep?
• Housing:
Where is s/he living? How long has s/he lived there? Is it a stable living
environment?
• Employment history:
Currently employed? When did s/he last work? How has his or her illness
affected his or her ability to work?
• Financial information:
Does s/he pay rent and other bills? Does s/he have insurance?
It is OK if you can’t answer all of these questions. It would be difficult to
provide information on all of these categories.
In some counties, if the family member is living in the community or in your
home, and you are the petitioner, you should not be surprised if you are asked to
arrange for an examiner to assess the individual and prepare a statement for the
court. You can talk to the person’s family doctor or psychiatrist.
ALTERNATIVES to INVOLUNTARY COMMITMENT
There are basically two alternatives to involuntary commitment to a psychiatric treatment facility to manage a psychiatric crisis: (1) Voluntary admission;
and (2) Managing the psychiatric problem on an outpatient basis. Both alternatives require cooperation from the person in crisis, which may be problematic.
The chances for cooperation can be increased by having a Psychiatric
Advance Directive (PAD). This is a document that is prepared in advance by a
person with serious mental illness (SMI) during a period of lucidity, in which
instructions for preferred modes of treatment in cases of psychiatric emergencies are specified, and power of attorney is granted to a trusted individual,
authorizing him or her to make medical decisions on behalf of the person with
SMI when he/she is not of sound mind. Although these Psychiatric Advance
Directives can be rescinded, they do increase the chances for cooperation by
the person who is in crisis.
Another approach, particularly if there is enough time available, is to benefit from the second half of the book by Xavier Amador, I Am Not Sick; I Don’t
Need Help. There, Amador outlines a specific series of steps that can be used
to persuade a person who has mental illness to cooperate with devising and
carrying through with a treatment plan.
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GLOSSARY
Listed below are acronyms and terms that might need some clarification:
24/7 – 24 hours a day, 7 days a week; usually used in reference to the time of
availability of services of some kind.
24 Hour Hold – See ID, Immediate Detention (page 16).
72 Hour Hold – See ED, Emergency Detention (below).
ACT – Assertive Community Treatment is a team approach that provides care
for persons with mental illness on a 24/7 basis, with the care brought to
the person’s residence, rather than requiring the person to come to a mental health facility. Usually restricted to treating the most severely ill, who
are least likely to be able to keep appointments.
Anosognosia – The condition in which a person with severe mental illness
(SMI), as a part of that illness, is unaware of his or her condition. It is
exhibited in approximately half of all persons with SMI. This condition
makes it especially problematic to get help for such persons. The book by
Xavier Amador, I’m Not Sick; I Don’t Need Help, is especially helpful in dealing effectively with this condition.
CIT – Crisis Intervention Team, a selected subset of emergency responders
(usually police) who volunteer to have targeted training in dealing effectively with persons who are in a mental health crisis. This training involves
learning about mental illness, and techniques of de-escalating crisis situations. A crucial part of a successful CIT program is to gain cooperation
with the local mental health facility that includes its agreeing to deal
promptly with persons in psychiatric crisis who are brought in to them,
allowing the CIT officer to return to duty with a minimum of delay. In calling 911 in a psychiatric emergency, one should always ask that a CIT officer
be sent to deal with it. If it turns out that your community does not have a
CIT program, work diligently to see to it that one is established as soon as
possible.
CMHC – Community Mental Health Center
ED – Emergency Detention, or 72-hour hold, can be put in effect when a
petitioner (who can be family, friend, or emergency responder, but most
often is a psychiatric worker at the institution to which the person in crisis
has been brought via a 24-hour hold) judges that the person in crisis cannot
be dealt with adequately in 24 hours. To put this in effect requires a petition that must be approved by a judge.
EDO – Emergency Detention Order, which is what a judge issues to authorize
an Emergency Detention (72-hour hold).
ER – Emergency Room, a section of a hospital that is set up to deal with crisis situations. No one can be denied treatment by emergency room personnel, regardless of whether or not the patient is able to pay for the services
rendered. It is also the most expensive form of medical care, but often the
only option that is immediately available.
15
Hearing on Order to Treat– A hearing by a judge of arguments by (usually) a
mental health facility to administer psychotropic medications to a person
with mental illness who does not wish to take them. This is distinct from a
commitment hearing, but can occur in the same session in which a commitment hearing is being conducted.
HIPAA – The acronym for the Health Insurance Portability and Accountability
Act of 1996 which, in addition to specifying conditions with regard to
insurance portability, puts restrictions on what can be revealed by a health
provider to persons other than the person being treated by the provider.
These restrictions can be a significant problem in managing the treatment
of a person with mental illness (or any other illness), and a great source of
frustration to family members and friends trying to improve that treatment.
One very important fact to keep in mind: HIPAA does not restrict what a
family member or friend can tell a health provider, and so HIPAA restrictions do not apply in instances in which this information is being offered.
ID – Immediate Detention, or 24-hour hold, can be ordered by an emergency
responder (usually a police officer) who believes that the person in crisis is
a danger to self or others, or is gravely disabled. This process does not
require the involvement of a judge.
IDO – Immediate Detention Order, which is what an emergency responder
issues to authorize a 24-hour hold. A judge is not needed in this process.
Imminent Risk of Harm – Situation in which there is an immediate danger of
self-harm being done, or harm to someone else, usually by a person with
mental illness who is in crisis. In Indiana, “imminent” is not a part of the
requirement for justifying involuntary hospitalization.
In-Service Training – On-the-job training designed to provide knowledge and
skills useful to improve performance of that job, or to extend the range of
activities associated with that job. CIT training is an excellent example of this,
as well as NAMI’s Provider Education Program for mental health providers.
MHC – Mental Health Center
MHP – Mental Health Provider
MICA – Mentally Ill/Chronically Addicted (dual diagnosis). Approximately
half of the population of persons with severe mental illness also have a
problem with substance abuse. In treatment, it is crucial to treat both
problems in parallel.
PAD – See Psychiatric Advance Directive (page 17)
PCP – Personal Care or Primary Care Physician (family doctor)
Petitioner – The person who files a petition with the court is called the petitioner. Any interested person may file a petition for commitment. The
petition tells the court the reasons the person with mental illness should
be committed. The family should do everything possible to make sure that
the petitioner is a professional such as a doctor, because the person with
mental illness is often angry at whoever initiates the process. Petitions are
often filed by hospitals or treatment facilities but family members and
people in the community may file them, too.
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Psychiatric Advance Directive (PAD) – This is a document that is prepared in
advance by a person with SMI during a period of lucidity, in which instructions for preferred modes of treatment in cases of psychiatric emergencies
are specified, and power of attorney is granted to a trusted individual,
authorizing him or her to make medical decisions on behalf of the person
with SMI when he/she is not of sound mind. Although these Psychiatric
Advance Directives can be rescinded, they do increase the chances for
cooperation by the person who is in crisis.
Respondent– The person who is being committed is called the respondent.
SED – Serious/Severe Emotional Disturbance (term used for children & juveniles)
SMI – Serious/Severe Mental Illness (term used for adults)
Triage – Process by which medical personnel decide whether a person (1) Is
beyond help, so that it is futile to try to provide help; (2) Has a serious
problem that can be helped, and requires their prompt attention; or (3)
Perhaps has a problem, but it is not as serious as the condition of persons
in category (2), and so providing help can be safely be deferred until the
persons in category (2) have been treated.
COMMUNITY MENTAL HEALTH CENTERS in INDIANA
IN A CRISIS OR A NON-CRISIS, COMMUNITY MENTAL HEALTH CENTERS PROVIDE MENTAL HEALTH SERVICES, USUALLY 24 HOURS A DAY,
SEVEN DAYS A WEEK. IF YOU HAVE ACCESS TO A CRISIS INTERVENTION TEAM, IT ALSO SERVES 24 HOURS A DAY, SEVEN DAYS A WEEK.
Anderson
Avon
Bloomington
Carmel
Columbus
East Chicago
Evansville
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Center for Mental Health, Inc.
1100 Broadway
PO Box 1258, Anderson, IN 46012
Phone: (765) 649-8161, Crisis Line: 765-649-8161
Web Access: www.cfmh.org
Serving: Madison County
Cummins Behavioral Systems, Inc.,
6655 East US 36, Avon, IN 46123
Phone: (317) 272-3330, Crisis Line: 888-244-6083
Web Access: www.cumminsbhs.com
Serving: Benton, Boone, Hendricks, Montgomery, Putnam,
Johnson, Marion, Tippecanoe, Vigo Counties.
Centerstone of Indiana
645 S. Rogers St., Bloomington, IN 47403
Phone: (812) 339-1691, Crisis Line: 812-339-1691
Web Page: www.the-center.org
Serving: Lawrence, Monroe, Morgan, Owen Counties.
BehaviorCorp, Inc.
697 Pro-Med Lane, Carmel, IN 46032
Phone: (317) 587-0500, Crisis Line:317-574-1252
Web Page: www.behaviorcorp.org
Serving Boone, Hamilton, Northern Marion County (Pike &
Washington Townships)
Centerstone of Indiana (East).
720 N. Marr Road, Columbus, IN 47201
Phone 812-314-3400, Crisis Line: 812-376-4888, or
1-800-832-5442. Web Page: www.quincoinc.com
Serving: Bartholomew, Brown, Decatur, Jackson, Jefferson,
Jennings, Clark Counties
Tri-City Comprehensive Mental Health Center, Inc. (Geminus)
3903 Indianapolis Blvd., East Chicago, IN 46312
Phone: (219) 398-7050, Crisis Line:219-392-6001
Web Access: www.tricitycenter.org
Serving: Lake County (North Township)
Southwestern Behavioral Health Care, Inc.
415 Mulberry St., Evansville, IN 47713
Phone: (812) 436-4221, Crisis Line:812-423-7791
Web Page: www.southwestern.org
Serving: Gibson, Posey, Vanderburgh, Warrick Counties
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Fort Wayne
Park Center, Inc.
909 E. State Blvd.
Fort Wayne, IN 46805
Phone: (260) 481-2721, Crisis Line: 260-481-2700
Web Page: www.parkcenter.org
Serving: Allen, Adams, Wells Counties
Gary
Edgewater Systems for Balanced Living, Inc.
1100 W. 6th Avenue
Gary, IN 46402
Phone: (219) 885-4264, Crisis Line: 219-885-4264
Web Page: www.edgewatersystems.org
Serving: Gary, Lake, & unincorporated Calumet Township
Goshen
Indianapolis
Oaklawn Community Mental Health Center, Inc.
330 Lakeview Drive, Goshen, IN 46257
Phone: (574) 533-1234, Crisis Line: 574-533-1234
Web Page: www.oaklawn.org
Serving: Elkhart County
Adult & Child Mental Health Center, Inc.
8320 Madison Avenue, Indianapolis, IN 46227
Phone: (317) 882-5122, Crisis Line: 317-882-5122
Web Page: www.adultchild.org
Serving: Marion, Johnson, Decatur, Perry, (Franklin Township of
Marion County), Beech Grove
Gallahue Mental Health Center
6950 Hillsdale Court, Indianapolis, IN 46250
Phone: (317) 588-7600, Crisis Line: 317-621-5700
Web Access: www.ecommunity.com
Serving: Marion County (Lawrence & Warren Townships);
Hancock and Shelby Counties
Midtown Community Mental Health Center
850 N. Meridian St., Indianapolis, IN 46202
Phone: (317) 630-8800, Crisis Line: 317-630-7791
Web Access: www.wishard.edu
Serving: Marion County
Jasper
Jeffersonville
Southern Hills Counseling Center
480 Eversman Drive, PO Box 769
Jasper, IN 47547-0769
Phone: (812) 482-3020, Crisis Line: 800-883-4020
Web Page: www.southernhills.org
Serving: Dubois, Crawford, Orange, Perry, Spencer Counties
Lifespring Mental Health Services
460 Spring St., Jeffersonville, IN 47130
Phone: (812) 280-2080, Crisis Line: 812-280-2080
Web Page: www.lifespr.com
Serving: Clark, Floyd, Harrison, Jefferson, Scott, Washington Counties
19
Kendallville
Kokomo
Lawrenceburg
Logansport
Marion
Merrillville
Michigan City
Muncie
Richmond
Northeastern Center
220 S. Main St.
PO Box 817, Kendallville, IN 46755
Phone: (260) 347-2453, Crisis Line:
Web Page: www.northeasterncenter.org
Serving: Dekalb, LaGrange, Noble, Steuben Counties
Howard Regional Health Systems
322 N. Main Street, Kokomo, IN 46902
Phone: (765) 453-8555, Crisis Line: 765-453-8555
Web Page: www.howardregional.org
Serving: Clinton, Howard, Tipton Counties
Community Mental Health Center, Inc.
285 Bielby Road, Lawrenceburg, IN 47025
Phone: (812) 537-1302, Crisis Line: 877-849-1248
Web Page: www.cmhcinc.org
Serving: Dearborn, Franklin, Ohio, Ripley, Switzerland Counties
Four County Counseling Center
1015 Michigan Avenue, Logansport, IN 46947
Phone: (574) 722-5151, Crisis Line: 800-552-3106
Web Page: www.fourcounty.org
Serving: Cass, Fulton, Miami, Pulaski Counties
Grant-Blackford Mental Health, Inc.
505 Wabash Avenue, Marion, IN 46952
Phone: (765) 662-3971, Crisis Line: 765-662-3971
Web Page: www.cornerstone.org
Serving: Grant, Blackford Counties
Southlake Center for Mental Health, Inc.
8555 Taft Street, Merrillville, IN 46410
Phone: (219) 769-4005; Crisis Line: 219-736-7200
Web Page: www.southlakecenter.com
Serving: South Lake County (includes St. John, Ross, Hobart,
Center, Hanover, Winfield West Creek, Cedar Creek, Eagle
Creek) and the town of Griffith.
Swanson Center
450 St. John Road, Suite 25
Michigan City, IN 46360
Phone: (219) 879-4621, 800-982-7123
or Crisis Line: 219-879-0676
Web Page: www.swansoncenter.org
Serving: LaPorte County
Meridian Services, Inc.
240 North Tillotson Avenue, Muncie, IN 47304
Phone: (765) 288-1928, Crisis Line: 765-288-1928
Web Page: www.meridiansc.org
Serving: Delaware, Henry, Jay, Meridian Counties
Dunn Mental Health Center
809 Dillon Road
Richmond, IN 47374
Phone: (765) 983-8006, Crisis Line: 765-983-8000
Web Page: www.dunncenter.org
Serving: Fayette, Randolph, Rush, Union, Wayne Counties
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South Bend
Madison Center, Inc
403 E. Madison St.
P.O. Box 80, South Bend, IN 46617
Phone: (574) 234-0061, Crisis Line: 800-234-0061
Web Page: www.madison.org
Serving: St. Joseph, Elkhart, Marshall, LaPorte Counties
Terre Haute
Hamilton Center, Inc.
620 8th Avenue,
Terre Haute, IN 47804
Phone: (812) 231-8323 Crisis Line: 812-231-8200 or:
800-742-0787
Web Page: www.hamiltoncenter.com
Serving: Clay, Greene, Marion, Owen, Parker, Putnam,
Sullivan, Vermillion, Vigo Counties
Valparaiso
Porter-Starke Services, Inc.
601 Wall Street, Valparaiso, IN 46383
Phone: (219) 531-3500, Crisis Line: 219-531-3500
Web Page: www.porterstarke.org
Serving: Porter, Starke Counties
Vincennes
Samaritan Center
515 Bayou St., Vincennes, IN 47591
Phone: (812) 886-6800, Crisis Line: 800-824-7907
Web Page: www.gshvin.org
Serving: Knox, Daviess, Martin, Pike Counties
Warsaw
Otis R Bowen Center for Human Services, Inc.
850 N. Harrison St., PO Box 497, Warsaw, IN 46581
Phone: (574) 267-7169, Crisis Line: 800-342-5653
Web Page: www.bowencenter.org
Serving: Huntington, Kosciusko, Marshall, Wabash, Whitley
Counties
West Lafayette Wabash Valley Hospital, Inc.
2900 N. River Road,West Lafayette, IN 47906
Phone: 765-463-2555, Crisis Line: 800-859-5553
Web Page: www.wvhmhc.org
Serving: Jasper, Newton, Carroll, White, Warren,
Montgomery, Tippecanoe, Benton, Fountain Counties
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RESOURCES and ACKNOWLEDGEMENTS
This booklet has been prepared for your use by:
National Alliance on Mental Illness Indiana (NAMI Indiana)
“Indiana’s Grass-Roots Voice on Mental Illness”
P.O. Box 22697, Indianapolis, IN 46222-0697
800-677-6442; Fax 317-925-9398
Web Page: www.namiindiana.org
Other useful sources of information can be found at the following web sites:
www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america.shtml
www.ninds.nih.gov/disorders
www.oas.samhsa.gov/
www.mayoclinic.com
www.psychlaws.org
www.allpsych.com/disorders
www.nami.org
www.nmha.org
Information Useful for Seniors:
Medicare: 1-800-772-1213 (Hearing or Speech Impaired: 1-800-325-0778)
The Geriatric Mental Health Foundation: 1-301-654-7850; www.GMFonline.org
Information Useful for Veterans:
Benefits Information:
Department of Veterans Affairs Regional Office: 1-800-827-1000
Healthcare Information: call one of these three campuses:
Fort Wayne VA Campus: 1-800-360-8387
Marion VA Campus: 1-800-498-8792
Roudebush VA Campus: 1-888-878-6889
If you don’t have a computer, you can ask the Technical Assistant in your
local library to contact NAMI Indiana’s web-site, www.namiindiana.org or
you can call NAMI at 1-800-677-6442, and NAMI will tell you and/or mail
you the information for dealing with a crisis in your county.
Acknowledgements:
This booklet’s creation has depended heavily on the crisis booklet created by NAMI Minnesota; permission for doing this has been graciously
provided by Sue Abderholden, NAMI Minnesota’s Executive Director, to
whom we are deeply grateful.
We are also indebted to Peg Lawson, Court Liaison, Park Center, Fort
Wayne, who painstakingly transcribed the Minnesota booklet into electronic format that could be adapted for our use, and to Judge David
Avery, Mental Health Court Judge, Allen County, who generously gave
of his time to provide the legal basis for detentions and involuntary
commitment in Indiana. A generous contribution from David Scheidler,
M.D. helped to defray the cost of printing this booklet. Kathleen
Coffee provided valuable proofreading and editorial assistance.
Also, our gratitude extends to:
NAMI Maryland – Janet Edelman
Pam McConey, NAMI Indiana, Executive Director
Dottie Davis, Deputy Chief, Fort Wayne Police Department
Paul Wilson, CEO, Park Center, Fort Wayne
NAMI Indiana Crisis Booklet/Web Site Committee members: Abby
Flynn (Chair), Pam McConey, Jane Novak, Phyllis Patton, Joe Vanable
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